The benefits of antioxidant-rich diet in treatment outcomes in childhood acute lymphoblastic leukemia

The study evaluated the effects of an antioxidant-rich diet in treatment outcomes during chemotherapy in children and adolescents with acute lymphoblastic leukemia (ALL). The main finding was that the intake of antioxidant-rich food alone reduced the risk of infections during treatment in such patients.

Several animal studies and clinical trials showed the benefits of antioxidant supplements on the effectiveness and toxicities of chemotherapy. However, these results were contradictory to other studies. The risks and benefits of dietary antioxidants during cancer therapy are unclear. Data from high-quality clinical trials on children and adolescents with ALL are also lacking.

This trial included 794 patients (aged 18 years or younger) with newly diagnosed ALL. They were treated using traditional chemotherapy guidelines. Antioxidant intake from diet alone or diet with supplements was monitored through questionnaires for 2 years.

513 patients completed questionnaires at diagnosis and end-of-induction therapy. Induction refers to initial therapy. 23% of them had bacterial infections or severe mucositis (inflammation of mucous membranes) at diagnosis. Such events occurred in 4% of patients at end-of-induction.

Antioxidants from the diet alone were associated with significantly reduced odds of developing an infection or mucositis in these patients. Among dietary antioxidants, carotenoids, β-carotene, and vitamin-A reduced risks of bacterial infection. High intake of vitamin-A, E, and zinc through diet alone lowered risks of mucositis. Risks of infection were similar among patients who did or did not use supplements.

549 patients achieved complete remission (CR) after induction. CR refers to the disappearance of clinical cancer symptoms. 16% of these patients had at least 1 bacterial infection and 10% faced mucositis during later treatments. Antioxidants from diet alone reduced risks of future mucositis in these patients.

Patients taking supplements experienced similar effects. A lower intake of vitamin-A and C during induction caused higher mucositis rates during future treatments. Dietary intake of antioxidants was not linked to relapse or cancer’s return. Survival without cancer was also not affected. Antioxidant supplements had no effects on relapse, survival, or treatment toxicity.

The authors concluded that a diet rich in antioxidants decreased infections in children and adolescents with ALL. 

The intake in antioxidants was based on patient-reported data. This might be affected by patient recollection. Further studies are needed.

If you have concerns regarding diet during treatment for ALL, please discuss this with your doctor.